Doctor Name: | MS. NAN IRENE MILLER |
NPI Number: | 1144351552 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L-CSW |
License Number: | R-041170-1 |
Business Practice Address: | 1000 Park Blvd Suite 201 Massapequa Park, NY - 117622740 |
Business Phone Number: | 9176470572 |
Business Fax Number: | |
Mailing Address: | 5 Madison Ln Apt 1f, CARLE PLACE |
State: | NY |
Postal Code: | 115141013 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/08/2007 |
NPI Last Update Date: | 04/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | R-041170-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |